Utilization Management RN (82964)

Posted 2 Days Ago
Be an Early Applicant
62794-9277, Springfield, IL, USA
In-Office
Junior
Healthtech • Professional Services • Social Impact
The Role
Reviews inpatient admissions and outpatient referrals across statewide systems to determine appropriate levels of care, medical necessity, and quality of care. Performs utilization management and review services while applying evidence-based criteria. Requires an active Illinois RN license, utilization review experience, CPR/BLS certification, proficiency with Microsoft Office, and ability to obtain a security clearance.
Summary Generated by Built In

Must be located in Illinois.

Centurion is proud to be the provider of comprehensive services to the Illinois Department of Corrections.   We are currently seeking a Full-time Utilization Management (UM) Registered Nurse (RN) to join our Regional Team in Springfield, Illinois. 

The UM RN is responsible for providing utilization review services for statewide systems.  This person reviews inpatient admissions and outpatient referrals to ensure appropriate levels of care and evaluate evidence based medical necessity and quality of care.

Qualifications
  • Licensed RN with an active license to practice in Illinois
  • Previous experience performing utilization review in an inpatient or outpatient setting or in a managed care setting
  • Proficiency in Microsoft Word and Excel required
  • Minimum of one year of work experience as an RN in a community outpatient clinic, hospital or long-term care facility preferred
  • Experience with InterQual preferred
  • Corrections experience preferred
  • Must be appropriately and actively certified in Cardio-Pulmonary Resuscitation (CPR)/ BLS
  • Ability to obtain a security clearance, to include drug screen and criminal background check

We offer excellent compensation and comprehensive benefits for our full-time team members including:

  • Health, dental, vision, disability and life insurance
  • 401(k) with company match
  • Generous paid time off
  • Paid holidays
  • Flexible Spending Account
  • Continuing Education benefits
  • Much more...

Skills Required

  • Active Illinois Registered Nurse license
  • Previous utilization review experience in an inpatient, outpatient, or managed care setting
  • Proficiency in Microsoft Word and Excel
  • At least one year of RN experience in a community outpatient clinic, hospital, or long-term care facility
  • Experience with InterQual
  • Corrections experience
  • Active CPR/BLS certification
  • Ability to obtain a security clearance, including drug screening and criminal background check
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The Company
HQ: Sterling, VA
9,000 Employees
Year Founded: 2011

What We Do

Centurion Health is a national leader in correctional healthcare, providing comprehensive medical, dental, and behavioral health services to incarcerated populations and other government agencies across numerous states.

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